Recently, Congress has focused on reforms to address pharmacy benefit managers’ (PBMs) role in high drug prices for patients. Congress must not excessively restrict PBMs’ ability to negotiate with manufacturers; alternatively, reforms could be paired with other policies that address the high prices of brand-name drugs.

This special JLME symposium addresses ways that federal policy can incentivize innovation in medical therapeutics and make pharmaceuticals more financially accessible.

Glucagon-like peptide-1 receptor agonists are effective for treating obesity, but the high cost of these medications endangers the financial viability of our health care system. To ensure that these drugs are available to Medicare beneficiaries, pharmaceutical manufacturers must lower their prices.

The European Commission’s proposal to address antimicrobial resistance using transferable exclusivity vouchers (TEVs) is fundamentally flawed. European policymakers and regulators should consider alternatives, such as better funding for basic and clinical research, use of advance market commitments funded by a pay-or-play tax, or enacting an EU Fund for Antibiotic Development.

Surprisingly little attention has been devoted to Musonius Rufus, a noted teacher and philosopher in first–century CE Rome, despite ample evidence for his impact in the period. This paper attempts to situate Musonius in relation to his philosophical predecessors in order to clarify both the contemporary status of the Stoic tradition and the value of engaging with the central figures of that school’s history. I make the case for seeing Cleanthes as a particularly prominent predecessor for Musonius and reaffirm (...) the importance of framing his philosophical commitments in the context of the Stoic tradition. On this latter point, I attempt to connect Musonius’ perspective on askesis and moral development with that of Posidonius (and Seneca). In doing so, I push back against the sometimes overly schematic intellectualism attributed to Stoic ethics generally. (shrink)

The possibility of cooperation and the stability of political order are long-standing problems. Polybius, well known for his Histories analysing the expansion of Rome and his description of the Roman constitution, also offers an intriguing social and political theory that covers ground from psycho-anthropological micro-foundations to institution-based political order, providing a genealogy of morals and political order that is best understood in game-theoretical terms. In this paper I try to give such an interpretation. Polybius’ naturalistic, proto-game theoretical views show (...) similarities with Hume, Smith and especially Hobbes’ doctrine of sovereignty by acquisition. However, Polybius is original in crucial regards, giving a motivationally plausible account of institutional and especially constitutional solutions to moral and political problems. Constitutional order, for Polybius, embodies and makes possible in the first place a kind of political reason that cannot be had individually. Polybian political theory thus offers interesting solutions to problems concerning moral motivation, collective action, and the conditions for political order, as well as the explanation and character of institutions. (shrink)

Arbitration is the dispute resolution method of choice in international commerce, but it rests on a complex legal foundation. In many international commercial contracts, the parties will choose the law governing any future disputes. However, where the parties do not choose a governing law, the prevailing approach in arbitration is to afford arbitrators broad and largely unfettered discretion to choose the law considered most appropriate or most applicable. The uncertainty resulting from this discretion potentially affects the parties' rights and obligations, (...) the performance of their contract, the presentation of their cases, and negotiations undertaken to settle their disputes.In this text, Dr Benjamin Hayward critically reviews the prevailing approach to the conflict of laws in international commercial arbitration. The text adopts a focused and detail-oriented analysis - being based on a study of more than 130 sets of arbitral laws and rules from around the world, and drawing heavily on arbitral case law. Nevertheless, it remains both practical and accessible, taking as its focus the needs and expectations of commercial parties, who are the ultimate users of international commercial arbitration.This text identifies the difficulties that result from resolving conflicts of laws through broad and unconstrained arbitral discretions. It establishes that a bright-line test would be a preferable way to resolve arbitral conflicts of laws. Specifically, it recommends a modified Art. 4 Rome Convention rule as the ideal basis for law reform in this area of arbitral procedure. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:At St. Isidore’s Franciscan College in Rome, the following maxim attributed to St. Patrick is inscribed above the door-way of the church: Si quae difficiles quaestiones in hac insula oriantur ad Sedem Apostolicam referantur; ut Christiani ita et Romani sitis.1 The college was founded in 1625 by Luke Wadding, O.F.M. and, under his direction, became a major seat of theological learning and political influence for the Irish in (...) Rome.2 In the nineteenth century, the Friars Minor of the Province of Ireland assigned many documents from St. Isidore’s for use in their Irish friaries. In 1872, amid the unrest caused by the Risorgimento, medieval and early-modern Irish Franciscan manuscripts were transferred to Dublin.3 At the Merchants’ Quay Convent, the librarians T.A. O’Reilly, O.F.M. and E.B. Fitzmaurice, O.F.M. divided the manuscripts into sections with alphabetically ordered shelf-marks.4 This practical approach followed the long-established system used at Italian libraries and archives in Franciscan custody.5 From 1947 until 2000, the manuscripts of the Irish Friars Minor were kept at the Franciscans’ Dún Mhuire House of Studies in Killiney, County Dublin, before their transfer to the Archives, University College Dublin.The ‘D’ collection is preserved in twenty-six sets of volumes, folders and boxed papers. The greater part consists of Luke Wadding’s correspondence, relating to his activities as theologian, historian, Irish agent in Rome and consultor to several congregations and commissions at the papal secretariat.6 In the 1920s, Paul Grosjean, S.J. included four manuscripts then housed at Merchants’ Quay in a catalogue of hagiographical works.7 Clement Schmitt, O.F.M. treated of a collection of the Franciscan documents kept in Dublin in 1964.8Letters to and from Luke Wadding are also preserved at the Vatican Library; the Archivo Generale at the General Curia of Friars Minor, Rome; the Biblioteca Landiana, Piacenza; the Biblioteca Nazionale, Naples; the Biblioteca Ambrosiana, Milan; the Archives of the Bollandists, Brussels; the Archives Générales de Royaume, Brussels; the Von Harrach Archive, Vienna; and the Franciscan friary of St. Jerome in Vienna.9Compared to some six hundred that Luke Wadding received, “the text of approximately one hundred of his letters, in whole or in part, has survived.”10 Nearly all Wadding’s extant correspondence dates from the three decades after the publication of his Acta legationis on the doctrine of the Immaculate Conception in 1624. Most of his letters were sent from St. Isidore, some from the friaries of Aracoeli and San Pietro in Montorio, Rome, and a few from Naples.11Luke Wadding was born in Waterford on October 16, 1588, the eleventh of fourteen children.12 He was baptized two days later on the Feast of St. Luke. His father Walter was a well-established Waterford merchant and his mother Anastasia a kinswoman of the prominent Lombard family of Waterford. After the death of his parents, Luke left Ireland with his elder brother, Matthew, who enrolled him at the Irish Jesuits’ College in Lisbon. At seventeen years of age, Wadding made his way to Matozinhos in northern Portugal, near Oporto, where he entered the Franciscan Order. On completion of his novitiate, Wadding’s superiors sent him to the University of Coimbra and from there, to Salamanca. At Easter 1613, Luke Wadding was ordained to the priesthood after his studies. He was then appointed as a professor of theology at the Franciscan College of León and later at his own alma mater, Salamanca.13Called to the Spanish capital, Luke Wadding stayed at the Convent of Jesus and Mary in the south-east of Madrid where “lived not only the heads of the Franciscan Order in Spain but also the principal preachers.”14 Such was the distinction Wadding achieved that he was chosen by Philip III for the office of theologian in the embassy sent to defend the doctrine of the Immaculate Conception in Rome.15 He lived there for almost forty years, in which time he founded St. Isidore Franciscan College, the.. (shrink)

I count myself privileged to respond to Kenneth Collins and Jerry Walls recent book on Roman Catholicism. I live in Fort Worth, TX, and I am a member of Wedgwood Baptist Church, which is one of more than 40,000 churches that together comprise the Southern Baptist Convention. I mention this so readers will know that my comments come from a conservative Evangelical Protestant perspective, and my thinking stems from a tradition that is decidedly not Roman Catholic. Having said this, I’m (...) much more sympathetic to Roman Catholicism than a great many Evangelicals, including Collins and Walls. I offer my criticisms of Rome, but I ask that readers not interpret me as someone who denies that the Roman Catholic Church counts as a Christian institution. In an effort to show good faith on this front, allow me to offer some defenses of Roman Catholicism against what I take to be over the top criticisms from some Protestant Evangelicals. (shrink)

La instauración de un vínculo entre historia y poder es uno de los aspectos más interesantes del pensamiento político de la filósofa francesa Simone Weil. Durante la primera mitad del siglo XX, Weil desarrolla unas reflexiones en torno al concepto de historia, desde la perspectiva de los vencidos, que aproximan su especulación a la de su contemporáneo Walter Benjamin. La comparación con Benjamin permite acercar el pensamiento weiliano a las recientes teorías de la justicia anamnética y, más en (...) general, a la exigencia actual de incorporar en el discurso político el punto de vista de las víctimas. (shrink)

Origin of the German Trauerspiel was Walter Benjamin's first full, historically oriented analysis of modernity. Readers of English know it as "The Origin of German Tragic Drama," but in fact the subject is something else--the play of mourning. Howard Eiland's completely new English translation, the first since 1977, is closer to the German text and more consistent with Benjamin's philosophical idiom. Focusing on the extravagant seventeenth-century theatrical genre of the trauerspiel, precursor of the opera, Benjamin identifies allegory (...) as the constitutive trope of the Baroque and of modernity itself. Allegorical perception bespeaks a world of mutability and equivocation, a melancholy sense of eternal transience without access to the transcendentals of the medieval mystery plays--though no less haunted and bedeviled. History as trauerspiel is the condition as well as subject of modern allegory in its inscription of the abyssal. Benjamin's investigation of the trauerspiel includes German texts and late Renaissance European drama such as Hamlet and Calderón's Life Is a Dream. The prologue is one of his most important and difficult pieces of writing. It lays out his method of indirection and his idea of the "constellation" as a key means of grasping the world, making dynamic unities out of the myriad bits of daily life. Thoroughly annotated with a philological and historical introduction and other explanatory and supplementary material, this rigorous and elegant new translation brings fresh understanding to a cardinal work by one of the twentieth century's greatest literary critics.--. (shrink)

Sheds new light on Heidegger's early theological development.

Despite their diversity, human languages share consistent properties and regularities. Wherefrom does this consistency arise? And does it tell us something about the problem that all languages need to solve? The authors provide an intriguing analyses which focuses on the “communicative function of ambiguity” whose resolution entailed an equally intriguing “speaker–listener cross‐entropy objective for measuring the efficiency of linguistic systems from first principles of efficient language use.”.

Pandemic plans recommend phases of response to an emergent infectious disease outbreak, and are primarily aimed at preventing and mitigating human-to-human transmission. These plans carry presumptive weight and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization. The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, this focus on human populations has resulted in strategically important disciplinary silos. As the (...) risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks. (shrink)

Featuring a new, explanatory Foreword by Justice Cardozo's premier biographer, this renowned and much-used analysis of the process of judicial decision-making includes embedded page numbers from the original 1921 edition for continuity of citations and syllabi.

With the godlike powers of modern technology, just one bad actor can unleash hell on Earth. In the face of this threat posed by technology, some have proposed moral bioenhancement as a solution. Although moral bioenhancement may at first seem like something Christian should support, it is my contention in this paper that there is at least one significant reason for Christians to be cautious in their appropriation of moral bioenhancement technology: it can at best give us a false apatheia, (...) which runs the ironic risk of destroying our ability to make moral progress. (shrink)

It is widely accepted in science that the universe is a closed deterministic system in which everything can, ultimately, be explained by purely physical causation. And yet we all experience ourselves as having the freedom to choose between alternatives presented to us — ‘we’ are in the driving seat. The puzzling status of volition is explored in this issue by a distinguished body of scientists and philosophers.

If the Bounded Proper Forcing Axiom BPFA holds, then Mouse Reflection holds at N₂ with respect to all mouse operators up to the level of Woodin cardinals in the next ZFC-model. This yields that if Woodin's ℙ max axiom (*) holds, then BPFA implies that V is closed under the "Woodin-in-the-next-ZFC-model" operator. We also discuss stronger Mouse Reflection principles which we show to follow from strengthenings of BPFA, and we discuss the theory BPFA plus "NS ω1 is precipitous" and strengthenings (...) thereof. Along the way, we answer a question of Baumgartner and Taylor. [2, Question 6.11]. (shrink)

The work of the contemporary French philosopher Jean-Luc Nancy has impacted across a range of disciplines. His writings on psychoanalysis, theology, art, culture and, of course, philosophy are now widely translated and much discussed. His L'Experience de la Liberte is considered to be one of the landmarks of contemporary continental philosophy. Jean-Luc Nancy and the Future of Philosophy is the first genuine introduction to Nancy's ideas and a clear and succinct appraisal of a burgeoning reputation. The book summarises topically the (...) primary conceptual areas of Nancy's thought and explores its relevance for contemporary issues like nationalism, racism and media rights. Nancy's indebtedness to Nietzsche, Heidegger, and Bataille is examined as well as how his ideas compare to those of his contemporary continental thinkers. Three major areas of Nancy's work are emphasised: freedom and morality; community and politics; and arts and the media. The reader is guided through a chosen theme without being lost in a welter of allusive language, jargon is avoided where possible and when unavoidable it is clearly explained. The book concludes with a new interview with Nancy, which discusses the future of philosophy. The book will be an important addition to the readings lists for courses on contemporary continental thought and political philosophy. (shrink)

Permaculture design seeks to create sustainable communities, and over time has established itself as a transnational community of practice. Based on original interviews with permaculture practitioners from around the world, and drawing on the three core elements of communities of practice - shared domain, communality and shared practices - as our analytical framework, this paper makes three arguments. First, the shared domain of permaculture as a body of knowledge, a system of ethics and set of practical design principles creates an (...) overarching teleological regime that anchors the globally dispersed collective activities of permaculture practitioners. Second, communality in the international permaculture community is centred around the permaculture design course, national and international permaculture convergences, and organisations and demonstration sites that act as hubs for practitioner interaction, linked across national borders by social media networks. Third, shared practices in the permaculture community centre on relationship-building and local-level community organisation. (shrink)

On February 3, 2010, a “Letter of Concern from Bioethicists,” organized by fetaldex.org, was sent to report suspected violations of the ethics of human subjects research in the off-label use of dexamethasone during pregnancy by Dr. Maria New. Copies of this letter were submitted to the FDA Office of Pediatric Therapeutics, the Department of Health and Human Services (DHHS) Office for Human Research Protections, and three universities where Dr. New has held or holds appointments. We provide a critical appraisal of (...) the Letter of Concern and show that it makes false claims, misrepresents scientific publications and websites, fails to meet standards of evidence-based reasoning, makes undocumented claims, treats as settled matters what are, instead, ongoing controversies, offers “mere opinion” as a substitute for argument, and makes contradictory claims. The Letter of Concern is a case study in unethical transgressive bioethics. We call on fetaldex.org to withdraw the letter and for co-signatories to withdraw their approval of it. (shrink)

The first philosophers of the Frankfurt School famously turned to the psychoanalytic theories of Sigmund Freud to supplement their Marxist analyses of ideological subjectification. Since the collapse of their proposed "marriage of Marx and Freud," psychology and social theory have grown apart to the impoverishment of both. Returning to this union, Benjamin Y. Fong reconstructs the psychoanalytic "foundation stone" of critical theory in an effort to once again think together the possibility of psychic and social transformation. Drawing on the (...) work of Hans Loewald and Jacques Lacan, Fong complicates the famous antagonism between Eros and the death drive in reference to a third term: the woefully undertheorized drive to mastery. Rejuvenating Freudian metapsychology through the lens of this pivotal concept, he then provides fresh perspective on Theodor Adorno, Max Horkheimer, and Herbert Marcuse's critiques of psychic life under the influence of modern cultural and technological change. The result is a novel vision of critical theory that rearticulates the nature of subjection in late capitalism and renews an old project of resistance. (shrink)

Radical virtue serves two distinct purposes: consolation in unfavorable circumstances, and prescription to achieve better ones. This paper maps out the theoretical nuances important for practical guidance. For a Stoic, radical virtue is a way to live well through environmental tragedy. For a consequentialist, it is an instrument to motivate us to combat climate change. For an Aristotelian, it is both. I argue that an Aristotelian approach fares the best, balancing the aim of external success with the aim of living (...) well through practical wisdom. This involves criticizing assumptions about living well that underlie behaviors that contribute to climate change. Some might object virtue theory suffers from application problems, and an Aristotelian approach suffers even more because it does not tell the virtuous person how to negotiate her aims. In response, Aristotelian revision starts with moral perception that adds valuable content by navigating through the messiness. (shrink)

Recent Darwin scholarship has provided grounds for recognising the Origin as a literary as well as a scientific achievement. While Darwin was an acute observer, a gifted experimentalist and indefatigable theorist, this essay argues that it was also crucial to his impact that the Origin transcended the putative divide between the scientific and the literary. Analysis of Darwin’s development as a writer between his journal-keeping on HMS Beagle and his construction of the Origin argues the latter draws on the pattern (...) of the Romantic or Kantian sublime. The Origin repeatedly uses strategies which challenge the natural-theological appeal to the imagination in conceiving nature. Darwin’s sublime coaches the Origin’s readers into a position from which to envision nature that reduces and contains its otherwise overwhelming complexity. As such, it was Darwin’s literary achievement that enabled him to fashion a new ‘habit of looking at things in a given way’ that is the centrepiece of the scientific revolution bearing his name. (shrink)

The authors put forward an interesting response to detractors of black box algorithms. According to the authors, what is of ethical relevance for medical artificial intelligence is not so much their transparency, but rather their reliability as a process capable of producing accurate and trustworthy results. The implications of this view are twofold. First, it is permissible to implement a black box algorithm in clinical settings, provided the algorithm’s epistemic authority is tempered by physician expertise and consideration of patient autonomy. (...) Second, physicians are not expected to possess exhaustive knowledge or understanding of the algorithmic computation by which they verify or augment their medical opinions. The potential of these algorithms to improve diagnostic and procedural accuracy alongside the quality of patient decision-making is undoubtedly a boon to modern medicine, but blind deference to them is neither feasible nor responsible, as several logistical and ethical quagmires noted by the authors still remain inherent in algorithmic software. I concur …. (shrink)

This article defends the normative relevance of the representation of non-citizens in democracies. I argue that representation within nation-states constitutes a realistic institutionalisation of the All-Affected Principle, allowing justificatory practices towards non-citizens and establishing political institutions that can realise the ideal of inclusion of all externally affected individuals. I defend electoral, non-electoral and surrogate forms of representation of affected interests that satisfy both the cosmopolitan concern for the equal consideration of interests and the statist defence of the importance of a (...) territorially and civically bounded demos. I assess piecemeal implementations of representation practices, namely reciprocal representation, ombudspersons, self-appointed representatives and deliberative and advocacy groups. Gradual and pluralised means of representation constitute necessary and feasible first steps to consider affected interests and offer an alternative route to an all-or-nothing defence of inclusion as national enfranchisement. (shrink)

Many friends of the category of particularised qualities subscribe to the view that particularised qualities have a unique bearer in which they inhere; no such quality then can inhere in two different entities. But it seems that this idea is flawed, for there are apparent counterexamples. An apple's redness is identical with the redness of its skin, though the apple is distinct from its skin. So it seems that a principle of bearer‐uniqueness has to be modified, maybe by excluding certain (...) unwanted cases. However, I argue that the need of a modification is not a direct consequence of the supposed counterexamples. Their dangerous potential for the principle arises if one takes the genitive in expressions of the form ‘a's F‐ness’ to signify the relation of inherence. I propose an alternative view: The genitive signifies a relation which is indeed closely related to inherence, but which is, contrary to inherence itself, partitive. That is, it may hold between a particularised quality and another entity because it holds between the quality and a part of the entity. If one regards the ontologically interesting relation of inherence as non‐partitive, one can still adhere to an unrestricted principle of bearer‐uniqueness. (shrink)

This paper explores the prospects of radical hope for addressing the devastation of the Covid-19 pandemic. Hope is useful for conceptualizing the proper balance between too much fear and too little about our uncertain future. First, I describe the ethical challenge of the pandemic as a wicked problem. Because accepted ethical theories fail to motivate solutions, wicked problems pressure us to develop our value systems, exercise moral imaginations, and discover creative solutions. Second, I develop an Aristotelian account of radical hope, (...) drawing from ancient philosophy, virtue ethics, and recent climate ethics. Radical hope is a novel form of courage, which balances the goal of external success, that something good will emerge from the tragedy, against the goal of living well for its own sake through practical wisdom. I conclude by applying some lessons to our present situation. (shrink)

At times of crisis, existing institutional arrangements of societies are thrown into question. Crises that occur in multiple societies simultaneously present rare opportunities for comparative empirical analysis. Social theory can reveal the framing conditions of the responses to crises and the sources of variations between them. This paper compares the immediate responses of the Australian, UK and US governments to the global COVID-19 pandemic, particularly with regard to financing lockdowns, and points out significant differences between the three approaches. Drawing on (...) Polanyi’s method of institutional analysis, we compare the responses of these same national groups to an earlier crisis, the Japanese prisoner of war camps during the Second World War, to show similar patterns of integration recurring eight decades apart. This analysis shows that aspects of moral economies that are not usually apparent can become pronounced during crises, and points to the importance of enduring social imaginaries. (shrink)

Since 2002, legislation in Spain has allowed for the creation and documentation of end-of-life decisionmaking. Over the intervening years, the actual implementation of such documents is very low. Through extensive analysis of the literature, this article explores the current status of the use of and attitudes toward advance directives in Spain and then proposes strategies for improvement in their implementation.

Eight focus groups were conducted in four public hospitals in Madrid to explore healthcare professionals’ perceptions of advance directives in order to improve the understanding of their lack of success among physicians and patients. A purposive sample of sixty healthcare professionals discussed ADs and reasons for their infrequent use. Three main themes were identified: perceptions about their meaning, appraisals of their use in clinical practice, and decision-making about them. Healthcare professionals perceived a lack of clarity about their definition and implementation. (...) There is insufficient awareness of their efficacy in improving the quality of clinical relationships and decision-making, and they are often perceived only as a bureaucratic procedure. Advance directives are not integrated in the clinical practice of Madrid’s healthcare specialist services because their application is exceedingly complex, because of insufficient education about them, and because of lack of procedural clarity. Consequently, healthcare professionals are not aware of how ADs could improve clinical decision-making, of when and for whom their use is appropriate, and of who has responsibility for providing ADs-related information to patients. These circumstances contribute to patients’ lack of interest in completing these documents and to physicians’ sceptical views about their usefulness. (shrink)